Manual ventilation therapy and aggressive potassium supplementation in the management of respiratory failure secondary to severe hypokalaemia in a cat with exocrine pancreatic insufficiency

Abstract

A domestic shorthair cat was referred for progressive muscle weakness and dyspnoea. The cat had a 2-month history of severe weight loss, small intestinal diarrhoea, polyphagia and polyuria/polydipsia. Biochemical analysis and venous blood gas evaluation revealed severe hypokalaemia [1.7 mmol/l; reference interval (RI): 3.5-5.1 mmol/l] and hypoventilation (partial pressure of carbon dioxide = 68 mmHg; RI: 34-38 mmHg). Aggressive potassium supplementation was initiated. The cat was manually ventilated until serum potassium increased to 3 mmol/l. A diagnosis of exocrine pancreatic insufficiency (EPI) was made based on clinical signs and serum feline trypsin-like immunoreactivity (0.1 μg/l; RI: 12-82 μg/l). Medical management of the EPI resulted in clinical recovery.

Exocrine pancreatic insufficiency with concurrent pancreatitis, inflammatory bowel disease and cholangiohepatitis in a cat

“…Other common biochemistry abnormalities are hypocholesterolaemia, hypocobalaminaemia and elevated folate concentration. Less common abnormalities associated with EPI are hyperglycaemia, in case of concurrent diabetes mellitus (Larsen 1993), hyperammonaemia caused by accumulation of methylmalonic acid due to cobalamin malabsorption (Watanabe and others 2012), hypokalaemia (Daste and others 2014) and vitamin K‐responsive coagulopathy (Perry and others 1991).…”

Signalment and Clinical Data of Cats with Exocrine Pancreatic Insufficiency Diagnosed Using Feline Trypsin-like Immunoreactivity in Routine Diagnostics

“…Cats with uncomplicated EPI have a good prognosis after adequate treatment [ 2 ]. However, individual critical cases, such as respiratory failure secondary to severe hypokalaemia [ 12 ] or vitamin K-responsive coagulopathy [ 13 ] due to malabsorption, are described as well.…”